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Full text of "Rapid Population Growth Consequences And Policy Implications"

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achieving their goals and aspirations, and who are exposed to the tubercle bacillus, may well be victims of tuberculosis. Similar individuals, not so exposed to the tubercle bacillus, who from childhood have lived on a high-saturated, fatty-acid diet, who tend to be sedentary, who smoke cigarettes heavily may well be victims of myocardial infarction. The point is that if the circumstances under which population density and crowding are deleterious to health are to be elucidated, it would seem important to recognize the limitations of the existing classificatory schemes used to identify disease entities. To a large extent, these schemes have been developed because of their usefulness for therapeutic purposes, but they may not be the best schemes for classifying diseases for the purpose of identifying the factors responsible for the origins of diseases.
On the basis of these findings and the theories that emerge from them, a number of predictions, or "working hypotheses," concerning the health consequences of future population growth and crowding can be advanced.
In most developing countries it can be anticipated that rapid population growth, particularly if associated with a deterioration in housing and nutritional status will, in all likelihood, be accompanied initially by increased death and disease rates. This increased health burden will be greatest on those segments of the population,who have had least previous experience with living in crowded conditions. Over a period of some decades, the diseases responsible for high death and morbidity rates will probably decline. Although overall disease rates will decline, "new" diseases will replace the old, requiring a major change in the nature and format of the health services. Whereas the diseases responsible for the initial rise in rates are likely to be diseases caused by acute infections and those associated with undernutrition and malnutrition, the later diseases are more likely to be chronic long-term disorders. Even though the rates for these disorders will be lower than for the acute diseases, the disability resulting from them will pose as great a strain on the national economy as did the high rates of the earlier diseases.
The more rapid the rate of population growth and the more it is accompanied by disruption of important social groups, the more dramatic will these effects be. The rate of population growth and the ensuing crowding will largely determine the ability of the population to adapt successfully to the new situation, and the degree to which new types of social groups can develop to fulfill the function originally played by the family and kinship group will in large part determine how deleterious such changes are.
Although the changing disease patterns are likely to occur in all developing countries undergoing rapid population growth, the specific diseases constituting this pattern are likely to vary. The particular diseases which will be